i can imagine a meta-study of the studies that look at the general prevalence of mental illness. this meta-study would look at the inflation curve of estimations of prevalence. perhaps the curve is rising faster than linear. the inflation curve might predict that it's just a matter of years before the entire population is mentally ill. or, at least, before the first studies come out with such a result.

Even if they used DSM criteria, the study could be very biased in favor of finding a mental disorder. How bad does a symptom have to be to "interfere with daily living activities"? Is it when you cut a lecture, or when you flunk out of school? When you attempt suicide, or when you spend a weekend in a blue funk? It’s all subjective.

The study got major funding from the American Foundation for Suicide Prevention, which has gotten targeted grants from the drug companies for programs to screen college students for mental illness (not just treat the ones who ask). AFSP unfortunately is closely tied to the pharmaceutical industry. Dr. Charles Nemeroff (recently forced to resign from Emory U.) is still listed as President of their Board of Directors.

Reminds me of NAMI which has taken to saying it speaks on behalf of "... the 50 million Americans living with a mental illness." That's one in six. Counting all the babies.

Johanna:

I do not know what the authors' threshold was for clinical distress or impairment, but I would hope it would not include missing a few lectures or feeling blue for a few days. However, if someone was missing enough classes that their grades are slipping, because they feel unmotivated to attend most of their classes while crying and feeling depressed on a daily basis for over two weeks, then I would consider a major depression, especially if other factors were involved.

Great work, by the way, on digging up the conflict of interest in the study. :)

Well, as a psychotherapist I believe these percentages are in the ballpark. I think we live in a society in which a lot of young adults are very anxious, depressed, and/or have unstable self-images and problems with affect regulation, impulse control, etc.

Adolescence itself in some ways is like a temporary personality disorder, which is to say that it's normal for young adults in a society like ours to feel some depression, anxiety, unregulated affect, disturbance of self-image, and so on. And many of them work their way through to adulthood without needing professional help.

But on the other hand, I wouldn't dismiss evidence that there may be a lot of young people who are really struggling. That certainly fits with what my colleagues and I see in our clinical practices.

Carol,

I wouldn't dismiss the evidence that a lot of young people are really struggling but on the other hand, 400 years ago most people died of starvation and other miserable sorts of things in their 20's so I don't really think anxiety is a disease. This doesn't mean unhappiness or embarrassing yourself at a college party is not a cause of unhappiness and doesn't provide you with something to discuss with a therapist but to say that this sort of angst is a struggle or a medical disease is nonsense. Wonder what's going on with the people this age who aren't in college? Next thing you know we'll have a study indicating that children of celebrities have a high incidence of mental illness, heirs to the throne are depressed? Not to be to pc but try homelessness and starving as a cure for ocd or adhd? These problems are invented luxuries.

Sally:

First, anxiety is not a disease. Everyone has anxiety, which is actually essential to our survival. However, if someone's anxiety becomes severe enough to the point that it is interfering with their life in a significant manner, then I would conceptualize that as an illness in need of treatment. Pain is also not a disease, but if someone was in extreme pain and unable to work or interact with people, then I would also not hesitate to suspect an underlying disease state.

Second, I suspect that a lot of our differences has to do with semantics. Perhaps if you defined what you meant by a "medical disease", then I would get a better sense of why you believe that mental illness is not a disease. Is your problem that there are no objective laboratory or imaging tests? If that is the case, then is delirium, dementia, and autism also not diseases?

Third, you are correct that some mental illness is a byproduct of living in a society where we have the capacity to indulge our wants, but that applies more to eating disorders rather than OCD and ADHD. Oh, and I have met homeless men with untreated OCD who were unable to pay their rent or work, because they were spending most of their time counting, checking, and other compulsive behaviors. So, tossing them on the street as a cure is neither helpful nor humane.